Study on drug utilization pattern of antibiotics among dermatology in-patients of a tertiary care teaching hospital, Karaikal, Puducherry

C. M. Divyashanthi, A. Nandhini, S. Adithiya Kumar

Abstract


Background: Skin diseases of microbial etiology are caused by bacteria, fungi, viruses and ectoparasites of which bacterial infections are most common than others. Although many bacteria reside on skin, they are unable to establish infection because of the natural defense mechanisms. Most of the bacterial infections are caused by Staphylococcus and Streptococcus. Antibiotic resistance among the micro-organisms is developing due to indiscriminate use of antibiotics and irrational prescription of drugs. Periodic study on drug utilization research and analysis of prescription pattern of antibiotics followed in recent past will guide physicians to prescribe the antibiotics judicially and with a rational approach.

Methods: A prospective analysis of 291 in-patients admitted in the Department of Dermatology, Karaikal, over a period of 1-year (January 2013-December 2013) was carried out to analyze the usage of antibiotics through various routes to treat infections associated with dermatological disorders.

Results: Among the study population, 60.48% were male and 39.51% were female. We found that out of 29 diseases observed, most common skin disease diagnosed was psoriasis (24.82%), followed by eczema (24.82%). The average number of drugs per prescription was 6.37±2.06. Oral antibiotics were mostly prescribed than parenteral and topical formulations among the study population. Among the oral antibiotics, amoxicillin with clavulanic acid (29.6%) was widely prescribed. In the context of parenteral formulations, cefotaxime (38.92%) was majorly prescribed. Among the topical antibiotics, mupirocin (60.71%) was mostly used.

Conclusion: Our study provided an idea about the prevalence of dermatological disorders in a coastal area of Karaikal, Puducherry, the drug utilization strategy of antibiotics, the rationality behind usage and has given useful suggestions to achieve treatment success through judicious use of antibiotics.


Keywords


Drug utilization research, Bacterial infections, Antibiotics, Dermatology inpatients and prescription analysis

Full Text:

PDF

References


Viswanath V, Coondoo A. IADVL’s Concise Text Book of Dermatology. 1st Edition. Oxford: Wiley-Black Well Publication; 2012: 2-3.

Harder J, Bartels J, Christophers E, Schröder JM. A peptide antibiotic from human skin. Nature. 1997;387(6636):861.

Chiller K, Selkin BA, Murakawa GJ. Skin microflora and bacterial infections of the skin. J Investig Dermatol Symp Proc. 2001;6(3):170-4.

Baur B, Sarkar J, Manna N, Bandyopadhyay L. The pattern of dermatological disorders among patients attending the skin OPD of a tertiary care hospital in Kolkata, India. J Dent Med Sci. 2013;3(4):04-9.

WHO Report on Infectious Diseases. Available at http://www.who.int/infectious- disease-report/pages. Accessed 12 Sep 2014.

Das KK. Pattern of dermatological diseases in Gauhati Medical College and Hospital Guwahati. Indian J Dermatol Venereol Leprol. 2003;69(1):16-8.

WHO. Epidemiology and Management of Common Skin Diseases in Children in Developing Countries. [WHOFCHCAH5.12]. Department of Child and Adolescent Health & Development, WHO; 2005:1-62.

Rao GS, Kumar SS, Sandhya S. Pattern of skin diseases in an Indian village. Indian J Med Sci, 2003;57(3):108-10.

Zamania A, Mahjum H. Prevalence of skin diseases in Hamedan, Iran in 2002. Indian J Dermatol. 2005;50(4):208-11.

Atraide DD, Akpa MR, George IO. The pattern of skin disorders in a Nigerian tertiary hospital. J Public Health Epidemiol. 2011;3(4):177-81.

Devi TB, Zamzachin G. Pattern of skin diseases in Imphal. Indian J Dermatol. 2006;51(2):149-50.

Williams HC. Epidemiology of skin diseases. Rook’s Textbook of Dermatology. 7th Edition. Oxford: Blackwell Science; 2004: 6.1-6.21.

World Health Organization. Global Burden of Disease for the Year 2001 by World Bank Region.” Disease Control Priorities Project. 2005. Available at http://www.fic.nih.gov/dcpp. Accessed 12 Sep 2014.

Group of Eight (2013). G8 science ministers statement. London UK: 12 June, 2013. Available at https://www.gov.uk/government/publications/g8-science-ministers-statement-london-12-june-2013. Accessed 12 Sep 2014.

World Health Organization. Antimicrobial resistance. Factsheet 194, 2013. Available at http://www.who.int/mediacentre/factsheets/fs194/en/. Accessed 12 Sep 2014.

Jesitus J. Dermatologists contribute to overuse of antibiotics. Derm Times, 01 Oct, 2013. Available at http://www.dermatologytimes.modernmedicine.com/dermatology-times/news/dermatologists-contribute overuse- antibiotics. [Accessed 12 Sep 2014].

Antibiotic resistance in dermatology and beyond your role in an emerging global health crisis. Available at http://www.epresspack.net/galderma-antibiotic-resistance-and- acne. Accessed 12 Sep 2014.

Sweileh WM. Audit of prescribing practices of topical corticosteroids in outpatient dermatology clinics in north Palestine. Eastern Mediterr Health J. 2006;12(1/2):161-9.

Sjoqvist F, Birkett D. Drug utilization. In: Bramley DW, editor. Introduction to Drug Utilization Research (WHO Booklet). New York: WHO Office of Publication; 2003: 76-84.

Michael JC, John T, Catherine H, Julie C, Victoria B, Rachid TA, et al. An audit of adverse drug reactions to aqueous cream in children with atopic eczema. Pharm J. 2003;27(1):747-8.

Narwane SP, Patel TC, Shetty YC, Chikhalkar SB. Drug utilization and cost analysis for common skin diseases in dermatology OPD of an Indian tertiary care hospital-A prescription survey. Br J Pharm Res. 2011;1(1):9-18.

Bijoy KP, Vidyadhar RS, Palak P, Chintan SP, Atmaram PP. Drug prescribing and economic analysis for skin diseases in dermatology OPD of an Indian tertiary care teaching hospital: a periodic audit. Indian J Pharm Pract. 2012;5(1):28-33.

Sarkar C, Das B, Sripathi H. Drug prescribing pattern in dermatology in a teaching hospital in western Nepal. J Nepal Med Assoc. 2001;41:241-6.

Das S, Chatterjee T. Pattern of skin diseases in a peripheral hospital’s skin OPD: a study of 2550 patients. Indian J Dermatol. 2007;52(2):93-5.

Sajith M, Lokhande KD, Padma S, Pawar AP. Prevalance of various skin disorders and prescribing pattern of antihistamines in tertiary care hospital, Pune. Int J Pharm Sci Res. 2014;5(03):73-7.

Symvoulakis EK, Krasagakis K, Komninos ID, Kastrinakis I, Lyronis I, Philalithis A, et al. Primary care and pattern of skin diseases in a Mediterranean island. BMC Fam Pract. 2006;7:6.

Asokan N, Prathap P, Ajithkumar K, Ambooken B, Binesh VG, George S. Pattern of skin diseases among patients attending a tertiary care teaching hospital in Kerala. Indian J Dermatol Venereol Leprol. 2009;75(5):517-8.

Malhotra SK, Malhotra S, Dhaliwal GS, Thakur A. Bacteriological study of pyodermas in a tertiary care dermatological center. Indian J Dermatol. 2012;57(5):358-61.

Kalshetti VT, Bhate VM, Haswani N, Bothikar ST. Staphylococcus aureus: a Major causative agent of community-acquired pyoderma. Int J Curr Microbiol Appl Sci. 2014;3(9):94-7.

Feingold DS. Antibiotic usage in dermatology. APUA Newsl. 1999;17(3):1, 4-5.

Tomecki KJ. Common Skin Infections. Available at http://www. clevelandclinicmeded.com/medicalpubs/diseasemanagement. Accessed 12 Sep 2014.

Sunderkötter C, Herrmann M, Jappe U. Antimicrobial therapy in dermatology J Dtsch Dermatol Ges. 2006;4(1):10-27.

Khan NA, Abid M, Maheswari KK, Kaviarasan PK, Mohanta GP. Antibiotic prescribing pattern in department of dermatology of a teaching hospital in Tamil Nadu. Indian J Pharm Pract. 2010;3(3):18-21.

Drucker CR. Update on topical antibiotics in dermatology. Dermatol Ther. 2012;25(1):6-11.